Efficacy and Safety of Two Different n-Butyl-2-Cyanoacrylates for the Embolization of Varicoceles: A Prospective, Randomized, Blinded Study

• Published in: Cardiovascular and interventional radiology Vol. 35; no. 3; pp. 598 - 606
• Main Authors: Vanlangenhove, Peter, De Keukeleire, Katrien, Everaert, Karel, Van Maele, Georges, Defreyne, Luc
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01-06-2012; Springer Nature B.V
• Subjects: Adult; ADULTS; AGE GROUPS; ARMS; BLOOD VESSELS; BODY; Cardiology; CARDIOVASCULAR SYSTEM; Clinical Investigation; Embolization, Therapeutic - methods; Enbucrilate - therapeutic use; Ethiodized Oil - therapeutic use; Humans; Imaging; LIMBS; Male; MALES; Medicine; Medicine & Public Health; Nuclear Medicine; ORGANS; Phlebography; Prospective Studies; RADIATION PROTECTION AND DOSIMETRY; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; SAFETY; Statistics, Nonparametric; Tissue Adhesives - therapeutic use; Treatment Outcome; Ultrasound; Varicocele - diagnostic imaging; Varicocele - therapy; VEINS; Varicocele; Embolization; Tissue adhesives
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-011-0188-9

Purpose
This was a prospective, randomized, blinded comparative study of the efficacy and safety of two different
n
-butyl-2-cyanoacrylates (NBCAs) for embolization of varicoceles.
Methods
A total of 112 insufficient spermatic veins (left-sided,
n
 = 84; right-sided,
n
 = 28) that were diagnosed in 83 adult males were prospectively randomized for blinded embolization with NBCA (
n
 = 54; Histoacryl, Braun, Germany) or NBCA-MS (
n
 = 58; Glubran2, General Enterprise Marketing, Viareggio, Lucca, Italy). Handling, embolic efficacy, and safety of both NBCAs were compared according the fulfillment of a standardized embolization plan, the occlusive effect on the spermatic vein, and the sticking to the microcatheter. Statistical analysis was performed with the Mann–Whitney
U
test and the Fisher’s exact test.
Results
Patients of both study arms were comparable for age and clinical indication. Spermatic vein characteristics were comparable for varicocele classification and embolization side. Both NBCAs were equally efficient in occluding the spermatic vein and blocking reflux (NBCA,
n
 = 54/54, 100% vs. NBCA-MS,
n
 = 54/57, 94.7%;
P
 = 0.244). The embolization plan could be accomplished in an equal number of veins for both groups (NBCA,
n
 = 45/54, 83.3% vs. NBCA-MS,
n
 = 41/58, 70.7%;
P
 = 0.124). Adhesiveness of the glue to the microcatheter was the same in both NBCA groups (NBCA,
n
 = 25/54, 46.3% vs. NBCA-MS,
n
 = 29/58, 50%;
P
 = 0.71). No glue-related complications were noted.
Conclusions
NBCA and NBCA-MS are equally efficient and safe glues for embolization of varicoceles.